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I’m needed again.

I went in and they asked me to fill in a survey as to whether I fall asleep or doze in the following scenorios. I put 0 for all. Then I had to get my height, weight and blood pressure done. Luckily, I’m developing a rash on my form arms so that masked the self harm. It basically boils down to “it is a massive problem” and what he said was that I have to wear this watch thing for 4 weeks which measures… something that will tell him whether I am moving, resting. I thought heart rate but apparently it can pick up if I’m sitting docile and just moving a little. But I’m not getting this watch until the end of January, so not a lot came from there.

I went to school, RE was boring. Maths was okay in the sense I didn’t do any work but bad in the sense I didn’t do any work. Then at lunch I talked to ND and she told me she gets pretty badly bullied for being a lesbian and it totally threw me because everyone I knew treated her well. In health, last lesson, my teacher asked why I hadn’t handed in my health and social slip for work experience, I told her my dad wouldn’t sign it and she took that to mean we hadn’t decided yet. Whatever makes her happy.

My brother didn’t go to school, still coughing like a smoker. I felt bad for him. But we had to leave to get into a taxi at 4:15pm and off to the hospital we went. We arrived at 4:45pm, signed in and I made my dad a hot chocolate, but no sooner had we sat down, my psychiatrist came out and said “Mr B” and here I thought the appointment was for me. We sat down and he complimented how well I had presented my mood diary. He hadn’t really read it, I could tell. He did some maths, adding up how long in those 3 months I was depressed, manic and mixed episodes. He drew a diagram. It was two lines, a Y and an X axis and drew a wavy line with the bumps not venturing far, he then drew one where the bumps went way down into the negatives but not much higher in positives and then he drew me. I went up and down to both high and low but with more low. He said that it was best he stopped treating me due to the complexity of my case and that I just work with CAMHS. But he said that if he were to treat me he would give me antidepressants making sure there was a support system in place in case I reached mania or if it made me worse and willing to commit suicide (a rare side effect) and then set me on with some mood stabilizers but since he is not treating me, he told me to tell them that I had a support system and wanted the antidepressants. I think I might just do that. He then asked if I had any questions.We know what I asked…
“What do you think the most likely diagnosis is?”
“Bipolar Mixed Affective Disorder” Not knowing what that was I researched…

I found this definiton: Affective disorder refers to a mood disorder such as depression. Basically when a person is exhibiting more symptoms of depression than is typical of an individual with bipolar disorder.I also found this one: “Rarely, some people show features of both mania and depression at the same time. They are hyperactive while experiencing depressive mood. Such patients are said to have a mixed affective disorder.”
“Bipolar affective disorder, mixed is a subcategory of the disorder featuring mixed episodes. A mixed episode is characterized by a period of a week or more in which the symptoms of both a major depressive episode and a manic episode are present daily. These episodes may last from a week to a few months. The individual may experience mixed episodes, manic and/or depressed episodes over the course of the illness. A mixed episode may develop from a manic or a major depressive episode, or on its own.

The DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision) adds the suffix “rapid cycling” to the diagnosis if the individual experiences four or more mood episodes (depression, manic, or mixed) during a twelve month period. The suffix “with seasonal pattern” applies to bipolar affective disorder when the depressive component is temporally related to the season of the year (i.e., fall or winter). The suffix “with” or “without Interepisode Recovery” may also be applied.

A mixed episode may include anger, panic attacks, agitation, anxiety, restlessness, suicidal thoughts, persecutory delusions, hallucinations, and confusion. This disorder is not a result of drug abuse, a side effect of a prescription medicine, or a medical disease such as hyperthyroidism.

There is no single proven cause but the disorder is thought to be a biochemical problem related to lack of stability in transmission of nerve impulses in the brain. This biochemical imbalance makes individuals with bipolar affective disorder more vulnerable to emotional or physical stress.

Risk: Bipolar affective disorder can present at virtually any point across the life span but mixed episodes are more common in younger individuals and individuals over the age of 60. Bipolar affective disorder is a heritable biologic illness with occurrence higher in relatives of individuals with the condition. The presentation and course of bipolar affective disorder differs between women and men, depending on the subtype of the condition. The onset of the disorder tends to occur later in women than men, and women more often have a seasonal pattern for any depressive component. Mixed episodes may be more common in males than females. Women with bipolar affective disorder have an increased risk of experiencing additional episodes in the immediate postpartum period (DSM-IV-TR; Thase).

Incidence and Prevalence: Estimates of the lifetime prevalence of bipolar affective disorder from two major community surveys of the general population of the US vary from 1.0% to 1.6% of adults (Keck).”

There are some factors that may make you more likely to develop bipolar affective disorder.

Having a close relative with bipolar affective disorder I may increase your risk. If your mother, father, brother or sister has the condition, you may be up to nine times more likely to get bipolar affective disorder I and up to five times more likely to get bipolar affective disorder II.

Stressful events, such as the breakdown of a relationship or physical illness, may cause bipolar affective disorder episodes.

Problems with how your nerves in your brain work.

A chemical imbalance in your brain.

Emotional damage caused when you were a child, such as physical, sexual or emotional abuse.”

So much research…

That sounds right. I was happy how it went but not happy I wouldn’t see him again and was stuck with CAMHS pdoc.

It lost £45 to get there and back in a taxi.

As for my title as I now include them. My dad and brother need me and that washes the mixed episode back. My dad’s other eye began to show lights and now we worry that one’s going to0. But he is going to the doctor tomorrow. He actually did make an appointment at the private hospital for January but it’s become a forefront issue. My dad might then have to go to A and E according to the eye doctor he briefly spoke to privately. My brother is off school tomorrow anyway becase he’s still ill but I am going to school; mainly for sociology. So if my dad is taken to A and E, then it’s just a long process in which to get home. Get on one bus, go into town and then get on another one to go to another town, walk from there whilst ringing my older brother and telling him to come pick my brother and I up. But he’s hardly going to be rushed to A and E in a car ambulance. I think, like me, my father has a flair for the dramatic.